A Case of Idiopathic Thrombocytopenic Purpura during Pregnancy

Background: Idiopathic thrombocytopenic purpura (ITP) is one of the common causes of thrombocytopenia in the first and second trimesters of pregnancy. Herein, we report a pregnant woman with ITP with the aim to review the latest evaluation and treatment methods for ITP in the third trimester of pregnancy. Case description: The patient was a 23-year-old G2 P1 woman with gestational age of 33 weeks and 4 days, who was referred to hospital due to reduced platelet count (21,000) in the pregnancy screening tests. The patient was subjected to splenectomy after 3 weeks at gestational age of 36 weeks and 4 days, and cesarean section was performed concurrently to terminate the pregnancy. The patient was transferred to the ICU after surgery and was stable. The wound site was normal. Within a few days after the surgery, platelet levels increased to 80,000. Finally, the patient was discharged in a good general condition two weeks after the cesarean section, and was prescribed to take 5 mg prednisolone daily. Conclusion: ITP should be considered in all patients who are first diagnosed with single thrombocytopenia during pregnancy, especially if the condition is detected before the third trimester and with platelet count of less than 50,000. Depending on the course of the disease, patients should be thoroughly monitored for platelet levels for timely treatment